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Wisdom of the crowd: bright ideas and innovations from the teaching value and choosing wisely challenge
Neel Shah1, Andrew E Levy, Christopher Moriates
1N. Shah is founder and executive director, Costs of Care, Inc., and assistant professor of obstetrics, gynecology, and reproductive biology, Harvard Medical School, Boston, Massachusetts. A.E. Levy is resident advisor, Teaching Value Project, Costs of Care, Inc., Boston, Massachusetts, and resident in internal medicine, The University of Chicago Medical Center, Chicago, Illinois. C. Moriates is director of implementation initiatives, Costs of Care, Inc., Boston, Massachusetts, and assistant professor of medicine, University of California, San Francisco, San Francisco, California. V.M. Arora is director of education initiatives, Costs of Care, Inc., Boston, Massachusetts, and associate professor of medicine and director, Graduate Medical Education Clinical Learning Environment Innovation, The University of Chicago, Chicago, Illinois.
Problem:
Medical education has been cited as both part of the problems facing, and part of the solution to reforming, the increasingly challenging U.S. health care system which is fraught with concerns regarding the quality and affordability of care. To teach value in ways that are impactful, sustainable, and scalable, the best and brightest ideas need to be shared such that educators can build on successful existing innovations.
Approach:
To identify the most promising innovations and bright ideas for teaching value to clinical trainees, the authors hosted the "Teaching Value and Choosing Wisely Challenge." The challenge used crowdsourcing methods to solicit scalable, pedagogical approaches from across North America, and then draw generalizable lessons.
Outcomes:
The authors received 74 submissions (28 innovations; 46 bright ideas) from 14 students, 20 residents/fellows, 38 faculty members (ranging from instructors to full professors), and 2 nonclinical administrators. Submissions represented 14 clinical disciplines including internal medicine, emergency medicine, surgery, pediatrics, obstetrics-gynecology, laboratory medicine, and pharmacy. Thirty-nine abstracts focused on graduate medical education, 15 addressed undergraduate medical education, and 20 applied to both.
Next Steps:
The authors have solicited, shared, and described solutions for teaching high-value care to medical trainees. Challenge participants demonstrated commitment to improving value and ingenuity in addressing professional barriers to change. Further success requires strong local faculty champions and willing trainee participants. Additionally, the use of data to demonstrate the collective positive impact of these ideas and programs will be critical for sustaining pedagogical changes in the health professions.